THE
THIRD ELEMENT OF THE BLOOD AND THE MALARIA PARASITE. By Ronald
Ross, d.p.h. I.M.S., Berhampur, Ganjavi, Surgeon-Major, In a former paper in the Indian Medical Gazette (October 1893), while giving a general view of some studies in connection with the malaria parasite, I described the small amoeboid bodies and the spherical bodies (de petit et de mot/en volume) as natural appearances of the blood-plates. The remarks were necessarily brief, and the reader may have felt that they required considerable amplification because of the great interest and difficulty attending the much-vexed question of the third cellular element of the Besides giving rise to blood (blood-plates, &c.) several apparently distinct microscopical elements which have created much confusion in physiology, it is undoubtedly responsible for no less than five out of the dozen parasitic forms described by writers 011 malaria, and those the commonest, Before and perhaps the most important, of all. to certain forms not yet conthen proceeding sidered by me, namely, the corps en croissant and the very interesting corps No. 2 muni de filaments mobiles, which is the climax of Laveran's system, I propose to return to that part of the subject and to endeavour to remove a source of so much error by entering exhaustively into the structure of the third element, the forms in which it manifests itself, the reason why these different forms occur, the pseudo-parasites connected with each form and the method of solving the difficulty. The post-mortem changes of the leucocytes will also be described at some greater length, because of the close analogy which exists between them nnd those of the third element. It is necessary, I fear, to be very prolix, since a hasty and incomplete statement would but add to the confusion already attending a subject of so much difficulty. The blood really consists of five microscopic elements, and of five only, which are always to be found in every specimen when made properly?the corpuscles, the leucocytes, the third cellular element, the granulations and fibrils of fibrin and the minute, free, oscillating particles. We shall see presently that numerous other bodies which have been described as occurring in healthy blood under the names of Donne's globulins, elementary granules of Beale and Zimmerman (where these are not fibrin granulations), Max Schultzes bodies, Hayem's htematoblasts, Bizzozero's bodies, plaques or blood-plates, Norris's third element (?), Lewis and Cunningham's fragments of protoplasm, Beale's irregular masses of protoplasm, Osier's granular masses, and Edington's albocytes are all in reality aspects and phases of the third element, while various objects supposed to be peculiar to malarial blood, namely, chained spores (?), small amoeboid bodies, the important smaller corps spli&riques hystiques
INDIAN MEDICAL GAZETTE.
No. 2 of Laveran, the mature stellate or flagellate body of some writers (not Laveran's) and the very important sporulating forms, such as Golgi's free corps en rosace, which create such interest at present, are of a precisely similar nature. By the use of a correct method of stainelement is shown to consist of little third the ing in diameter, which lie cells, about singly or in clusters in the serum, number from five to a hundred or more in a field and are very similar in structure to the leucocytes ; but which are ordinarily invisible in unstained liquid blood, though the masses of them can be traced faintly as irregular masses of protoplasm and their postmortem phase is very conspicuous as the spherical bodies of Laveran, the free rosettes of Golgi and the albocytes of Edington?facts which have led to so much confusion. As Havem states, and as will be seen shortly, they constitute a veritable third cellular element whose existence we can doubt as little as that of the corpuscles and leucocytes. The term t: third element" was, however, used originsilly by Norris for a body which Mrs. Ernest Hart showed to be a forir. of red corpuscles, but which may possibly be Form C, below. The term "blood-plate" was applied in my former article to the little cells, in order to save explanations there ; but as it is a very incorrect oue, some such simple name as microcyte (which is of little use in its present connection as a email corpuscle) may perhaps be allowed for I shall begin then by describwant of a better. the different appearances assumed minutely ing in unstained third element the liquid blood, by that is, in ordinary cover glass specimens, the differences being due to varying degrees of visibility of the microcytes and to the curious post-mortem change which they undergo. We can distinguish three distinct forms, between which, at first sight, there appears to be no connection whatever. Form A?in which the constituent microcytes are faintly visible: globulins of Donne, Zimmerman's and Schultze's bodies, chained spores (?), zooglcea of micrococci, &c.: clusters or chains of very faint, sometimes brownish, little globules 1 fx in diameter, frequently adhering to the glass or to fibres, &c., seldom seen and then only in fresh blood in a state of motion, rapidly disappearing, almost entirely, especially when the The serum becomes stained with hasmoglobin. faintest possible indications of a matrix in which the globules are embedded may sometimes be distinguished, as also, rarely, a very faint yellow amaboid substance in connection with each little o-lobule. On the addition of water to liquid blood the globules swell up just as the leucocytes do and become much more visible, especially " " washed out; and we where the corpuscles are out in them a slightly eccentric may even make nucleus. To this form belong evidently the
THIRD ELEMENT OF THE BLOOD AND THE MALARIA PARASITE. By Ronald
Ross, d.p.h. I.M.S., Berhampur, Ganjavi, Surgeon-Major, In a former paper in the Indian Medical Gazette (October 1893), while giving a general view of some studies in connection with the malaria parasite, I described the small amoeboid bodies and the spherical bodies (de petit et de mot/en volume) as natural appearances of the blood-plates. The remarks were necessarily brief, and the reader may have felt that they required considerable amplification because of the great interest and difficulty attending the much-vexed question of the third cellular element of the Besides giving rise to blood (blood-plates, &c.) several apparently distinct microscopical elements which have created much confusion in physiology, it is undoubtedly responsible for no less than five out of the dozen parasitic forms described by writers 011 malaria, and those the commonest, Before and perhaps the most important, of all. to certain forms not yet conthen proceeding sidered by me, namely, the corps en croissant and the very interesting corps No. 2 muni de filaments mobiles, which is the climax of Laveran's system, I propose to return to that part of the subject and to endeavour to remove a source of so much error by entering exhaustively into the structure of the third element, the forms in which it manifests itself, the reason why these different forms occur, the pseudo-parasites connected with each form and the method of solving the difficulty. The post-mortem changes of the leucocytes will also be described at some greater length, because of the close analogy which exists between them nnd those of the third element. It is necessary, I fear, to be very prolix, since a hasty and incomplete statement would but add to the confusion already attending a subject of so much difficulty. The blood really consists of five microscopic elements, and of five only, which are always to be found in every specimen when made properly?the corpuscles, the leucocytes, the third cellular element, the granulations and fibrils of fibrin and the minute, free, oscillating particles. We shall see presently that numerous other bodies which have been described as occurring in healthy blood under the names of Donne's globulins, elementary granules of Beale and Zimmerman (where these are not fibrin granulations), Max Schultzes bodies, Hayem's htematoblasts, Bizzozero's bodies, plaques or blood-plates, Norris's third element (?), Lewis and Cunningham's fragments of protoplasm, Beale's irregular masses of protoplasm, Osier's granular masses, and Edington's albocytes are all in reality aspects and phases of the third element, while various objects supposed to be peculiar to malarial blood, namely, chained spores (?), small amoeboid bodies, the important smaller corps spli&riques hystiques
INDIAN MEDICAL GAZETTE.
No. 2 of Laveran, the mature stellate or flagellate body of some writers (not Laveran's) and the very important sporulating forms, such as Golgi's free corps en rosace, which create such interest at present, are of a precisely similar nature. By the use of a correct method of stainelement is shown to consist of little third the ing in diameter, which lie cells, about singly or in clusters in the serum, number from five to a hundred or more in a field and are very similar in structure to the leucocytes ; but which are ordinarily invisible in unstained liquid blood, though the masses of them can be traced faintly as irregular masses of protoplasm and their postmortem phase is very conspicuous as the spherical bodies of Laveran, the free rosettes of Golgi and the albocytes of Edington?facts which have led to so much confusion. As Havem states, and as will be seen shortly, they constitute a veritable third cellular element whose existence we can doubt as little as that of the corpuscles and leucocytes. The term t: third element" was, however, used originsilly by Norris for a body which Mrs. Ernest Hart showed to be a forir. of red corpuscles, but which may possibly be Form C, below. The term "blood-plate" was applied in my former article to the little cells, in order to save explanations there ; but as it is a very incorrect oue, some such simple name as microcyte (which is of little use in its present connection as a email corpuscle) may perhaps be allowed for I shall begin then by describwant of a better. the different appearances assumed minutely ing in unstained third element the liquid blood, by that is, in ordinary cover glass specimens, the differences being due to varying degrees of visibility of the microcytes and to the curious post-mortem change which they undergo. We can distinguish three distinct forms, between which, at first sight, there appears to be no connection whatever. Form A?in which the constituent microcytes are faintly visible: globulins of Donne, Zimmerman's and Schultze's bodies, chained spores (?), zooglcea of micrococci, &c.: clusters or chains of very faint, sometimes brownish, little globules 1 fx in diameter, frequently adhering to the glass or to fibres, &c., seldom seen and then only in fresh blood in a state of motion, rapidly disappearing, almost entirely, especially when the The serum becomes stained with hasmoglobin. faintest possible indications of a matrix in which the globules are embedded may sometimes be distinguished, as also, rarely, a very faint yellow amaboid substance in connection with each little o-lobule. On the addition of water to liquid blood the globules swell up just as the leucocytes do and become much more visible, especially " " washed out; and we where the corpuscles are out in them a slightly eccentric may even make nucleus. To this form belong evidently the
